Pacific Holistic Dental, Inc. is a dental clinic (Dentist) in Nipomo, California. The current practice location for Pacific Holistic Dental, Inc. is 530 W Tefft St, Nipomo, California. For appointments, you can reach them via phone at
(805) 929-6814. The mailing address for Pacific Holistic Dental, Inc. is 530 W Tefft St, Nipomo, California and phone number is (805) 929-6814.
Pacific Holistic Dental, Inc. is licensed to practice in California (license number 57466) and its
NPI number is 1780900480. This medical practice
does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at
(805) 929-6814.
Dental Care Clinic Profile
| Full Name | Pacific Holistic Dental, Inc. |
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| Speciality | Dentist |
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| Location | 530 W Tefft St, Nipomo, California |
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| Authorized Official Name and Position | Edward Shapiro (OWNER/ OPERATOR) |
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| Authorized Official Contact | 8059296814 |
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| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Pacific Holistic Dental, Inc.
530 W Tefft St
Nipomo
CA 93444-8946
Ph: (805) 929-6814 | Pacific Holistic Dental, Inc.
530 W Tefft St
Nipomo
CA 93444-8946
Ph: (805) 929-6814 |
NPI Details:
| NPI Number | 1780900480 |
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| Provider Enumeration Date | 04/20/2010 |
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| Last Update Date | 09/26/2011 |
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Medical Identifiers
Medical identifiers for Pacific Holistic Dental, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1780900480 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 57466 (California) | Primary |
| 1223E0200X | Dentist - Endodontics | 57466 (California) | Secondary |
| 1223G0001X | Dentist - General Practice | 57466 (California) | Secondary |
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | 57466 (California) | Secondary |
| 1223P0221X | Dentist - Pediatric Dentistry | 57466 (California) | Secondary |
| 1223P0300X | Dentist - Periodontics | 57466 (California) | Secondary |
| 1223P0700X | Dentist - Prosthodontics | 57466 (California) | Secondary |
| 171100000X | Acupuncturist | 57466 (California) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | 57466 (California) | Secondary |
| 208VP0000X | Pain Medicine - Pain Medicine | (* (Not Available)) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | (* (Not Available)) | Secondary |
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